Revenge of the HIRDs—The New Massachusetts Employer Healthcare Coverage Form

Revenge of the HIRDs—The New Massachusetts Employer Healthcare Coverage Form

In a series of recent posts (available here and here), we discussed the expanded Massachusetts Employer Medical Assistance Contribution (EMAC) requirements, including the adoption of a new EMAC supplemental contribution. Among other things, we explained that the EMAC rules operate in a manner that is fundamentally different from the now repealed “fair share employer contribution” requirement under the 2006 Massachusetts health care reform law. Under that law, employers were obligated to (among other things) obtain signed forms—referred to as Health Insurance Responsibility Disclosure (or “HIRD”) forms. While the HIRD form requirements were repealed effective July 1, 2013, there is now a new HIRD form requirement with which employers will need to contend.

The purpose of the new HIRD form is to collect employer-level information about employer-sponsored insurance offerings, in order to assist MassHealth in identifying individuals with access to employer-sponsored insurance who may be eligible for MassHealth’s Premium Assistance Program. In the Commonwealth’s view, the new HIRD form is designed as a program integrity initiative aimed at enhancing its Premium Assistance Program. The new HIRD requirement is established by Section 12 of the bill H. 4008, which amends M.G.L. ch. 118E with a new Section 78, which reads, in relevant part:

Section 78. (a) The division shall create an employer healthcare coverage form. Every employer with 6 or more employees, doing business in the commonwealth, shall annually complete and submit the form under oath. The form shall indicate whether the employer has offered to pay or arrange for the purchase of health care insurance and information about such health care insurance such as the premium cost, benefits offered, cost sharing details, eligibility 186 criteria and other information deemed necessary by the division; provided, that the information collected through the form shall not be used to deny or terminate MassHealth eligibility for non-disabled persons who would otherwise qualify for a program of medical benefits pursuant to this 189 chapter who have access to employer sponsored health insurance.

While the statute refers to an “employer healthcare coverage form,” MassHealth refers to this as a “HIRD” from. Irrespective of what it is called, the new reporting requirement will be administered by MassHealth and the Massachusetts Department of Revenue through web-based reporting that should be available later this year. We emphasize that this new reporting requirement is separate and distinct from the EMAC supplement reporting requirement.

Despite that the new HIRD form is not required to be filed until later this year, MassHealth officials have reached out to a handful of Massachusetts employers asking for early compliance in an effort to test their reporting systems and procedures. This early request asks employers to complete an Excel spreadsheet. As we note above, the permanent reporting system will be a web-based portal.

We encourage employers receiving this request from MassHealth for early compliance to lend a hand in the establishing of the program. It’s a safe bet that the Commonwealth’s early experience will result in a more streamlined and useful final product.